Are probiotics a feasible intervention for prevention of diarrhoea in the developing world?

With more than 1.4 million of the 9 million child deaths being attributed to diarrhoea in 2008 and 49% of them occurring in five countries namely, India, Nigeria, Democratic Republic of the Congo, Pakistan and China, there is an urgent need for intervention to prevent and control diarrhoeal diseases. Of the various interventions, probiotics offer immense potential. The past decade has witnessed the validation of their utility for the prevention, treatment and management of a variety of infective and non infective disorders. The most investigated field continues to remain infectious diarrhoea and compelling evidence comes from randomized placebo controlled trials. While results from these studies are encouraging most of them reflect the outcomes of the developed world. Developing countries like India continue to struggle with nutritional and health challenges and bear the greatest burden of diarrhoea. A paucity of data from the developing countries limits the definite recommendation of probiotics. In these countries curd, often confused for a probiotic, is practiced as an integral part of the culture. While the nutritional benefits of these products cannot be understated, it is still uncertain whether these products can be classified as a probiotic. The emergence of probiotic foods which are scientifically validated for their efficacy and impart defined health benefits offer an excellent opportunity to improve public health. A recent randomized controlled trial conducted by the National Institute of Cholera and Enteric Diseases in Kolkata, India demonstrated a protective efficacy of 14% in preventing diarrhoea among children who received a probiotic. For the developing world however the vision for probiotics would mean a fundamental change in perception and developing a well planned strategy to allow interventions like probiotics to permeate to impoverished settings, where the assault of micro organisms is on a daily basis. This would mean that probiotics are ingrained into the public health system without being seen as a medicine

Comparative analysis of emm type pattern of Group A Streptococcus throat and skin isolates from India and their association with closely related SIC, a streptococcal virulence factor

<p>Abstract</p> <p>Background</p> <p>Group A streptococcus (GAS) causes a wide variety of life threatening diseases in humans and the incidence of such infections is high in developing countries like India. Although distribution of <it>emm </it>types of GAS in India has been described, there is a lack of data describing either the comparative distribution of <it>emm </it>types in throat versus skin isolates, or the distribution of certain virulence factors amongst these isolates. Therefore in the present study we have monitored the <it>emm </it>type pattern of Group A streptococcus throat and skin isolates from India. Additionally, the association of these isolates with closely related <it>sic </it>(<it>crs</it>), a multifunctional compliment binding virulence factor, was also explored.</p> <p>Results</p> <p>Of the 94 (46 throat and 48 skin) isolates analyzed, 37 <it>emm </it>types were identified. The most frequently observed <it>emm </it>types were <it>emm</it>49 (8.5%) and <it>emm</it>112 (7.5%) followed by 6.5% each of <it>emm</it>1-2, <it>emm</it>75, <it>emm</it>77, and <it>emm</it>81. Out of 37 <it>emm </it>types, 27 have been previously reported and rest were isolated for the first time in the Indian Community. The predominant <it>emm </it>types of throat (<it>emm</it>49 and <it>emm</it>75) samples were different from those of skin (<it>emm</it>44, <it>emm</it>81 and <it>emm</it>112) samples. After screening all the 94 isolates, the <it>crs </it>gene was found in six <it>emm</it>1-2 (<it>crs</it>1-2) isolates, which was confirmed by DNA sequencing and expression analysis. Despite the polymorphic nature of <it>crs</it>, no intravariation was observed within <it>crs</it>1-2. However, insertions and deletions of highly variable sizes were noticed in comparison to CRS isolated from other <it>emm </it>types (<it>emm</it>1.0, <it>emm</it>57). CRS1-2 showed maximum homology with CRS57, but the genomic location of <it>crs</it>1-2 was found to be the same as that of <it>sic</it>1.0. Further, among <it>crs </it>positive isolates, <it>spe</it>A was only present in skin samples thus suggesting possible role of <it>spe</it>A in tissue tropism.</p> <p>Conclusion</p> <p>Despite the diversity in <it>emm </it>type pattern of throat and skin isolates, no significant association between <it>emm </it>type and source of isolation was observed. The finding that the <it>crs </it>gene is highly conserved even in two different variants of <it>emm</it>1-2 GAS (<it>spe</it>A +ve and -ve) suggests a single allele of <it>crs </it>may be prevalent in the highly diverse throat and skin isolates of GAS in India.</p

Partial characterization of a 36-kDa antigen of Entamoeba histolytica and its recognition by sera from patients with amoebiasis

A 36-kDa antigen of axenically grown pathogenic Entamoeba histolytica (HM1-IMSS) was eluted from the sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)-resolved crude amoebic extract antigens. The immunoreactivity of this partially purified 36-kDa antigen with monoclonal antibody (MoAb) 3D10 altered significantly (P&lt;0.01) after heat and trypsin treatment but remained unaltered after treatment with sodium metaperiodate (P&gt;0.5), thereby indicating the protein nature of the epitope recognized by MoAb 3D10. The epitope was found to be localized on the surface as well as in the cytoplasm of the E. histolytica trophozoites with the majority of it in the cytoplasm. In addition, this epitope was also found to be present on the cyst form of the parasite. The 36-kDa molecule was recognized by the sera from 29 (85%) of the 34 patients with amoebic liver abscess and five (83%) of the six patients with amoebic colitis. No serum samples from asymptomatic cyst passers, from patients with non-amoebic hepatic or intestinal disorders and apparently healthy subjects had antibodies that reacted with this 36-kDa molecule. The immune responses in man to this 36-kDa amoebic molecule indicate a potential specific role for this molecule in invasive amoebiasis

Health impact of probiotics - vision and opportunities

Our understanding of the role of the microbiota in our gut and other sites in our body is rapidly emerging and could lead to many new and innovative approaches for health care. The promise of the potential role of probiotics for the prevention and treatment of enteric and other infections as an effective solution needs to be realized. The meeting report summarizes the insights and learning from a recent symposium, "Health Impact of Probiotics - Vision and Opportunities" conducted in Mumbai by the Yakult India Microbiota and Probiotic Science Foundation and P.D. Hinduja National Hospital, Mumbai. The symposium reflected its objective of unraveling the potential role of probiotics for health benefits through presentations and discussions. Experts clearly highlighted the role of probiotics in improving various aspects of health and in immune modulation. The report also captures the debate and discussions on the challenges that are likely to be encountered for the use of probiotics in the country

Immune effector responses to an excretory-secretory product of Giardia lamblia

The prior immunisation of mice with purified excretory-secretory product (ESP) led to a complete failure of Giardia lamblia colonisation following challenge inoculation of these animals with trophozoites. The prior immunisation of mice with ESP resulted in a significant stimulation of local immunity as evidenced by a significant enhancement of T helper/inducer activity along with a significant increase in immunoglobulin A-bearing cells. Further, the presence of anti-ESP antibodies in the serum of immunised as well as immunised-challenged animals indicated the stimulation of the systemic lymphoid system. This suggests that the ESP is highly immunogenic and it could be one of the major antigens of G. lamblia responsible for protection against the infection

Characterization of adhesin variants in Indian isolates of enteroaggregative Escherichia coli

Enteroaggregative Escherichia coli (EAEC) are causative agents of diarrhea, being characterized by aggregative adherence to cultured epithelial cells. In this study, phenotypic properties of EAEC were analyzed with respect to AA, hemagglutination, clump and biofilm formation, all of which are mediated by aggregative adherence fimbriae (AAF). The strains were also screened for AAF types, AAF adhesin variants and Dr adhesin by PCR. Of the three known AAF types, AAF/I and AAF/II adhesin variants were identified. An association between the AAF/adhesin genotypes and the subtypes/scores of phenotypic properties was sought and it was observed that strains harboring same adhesins displayed different subtypes/scores and vice versa

Predicting COVID-19—Comorbidity Pathway Crosstalk-Based Targets and Drugs: Towards Personalized COVID-19 Management

It is well established that pre-existing comorbid conditions such as hypertension, diabetes, obesity, cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), cancers, and chronic obstructive pulmonary disease (COPD) are associated with increased severity and fatality of COVID-19. The increased death from COVID-19 is due to the unavailability of a gold standard therapeutic and, more importantly, the lack of understanding of how the comorbid conditions and COVID-19 interact at the molecular level, so that personalized management strategies can be adopted. Here, using multi-omics data sets and bioinformatics strategy, we identified the pathway crosstalk between COVID-19 and diabetes, hypertension, CVDs, CKDs, and cancers. Further, shared pathways and hub gene-based targets for COVID-19 and its associated specific and combination of comorbid conditions are also predicted towards developing personalized management strategies. The approved drugs for most of these identified targets are also provided towards drug repurposing. Literature supports the involvement of our identified shared pathways in pathogenesis of COVID-19 and development of the specific comorbid condition of interest. Similarly, shared pathways- and hub gene-based targets are also found to have potential implementations in managing COVID-19 patients. However, the identified targets and drugs need further careful evaluation for their repurposing towards personalized treatment of COVID-19 cases having pre-existing specific comorbid conditions we have considered in this analysis. The method applied here may also be helpful in identifying common pathway components and targets in other disease-disease interactions too